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Case Studies

The Innovation Case Studies section provides a comprehensive list of exemplar innovation projects from across the NHS. These innovations have been carefully selected to represent a range of ideas from medical technologies through to service and pathway re design. Each case study provides a background to the innovation and a contact for further information.

Click on the Case Study Browse area on the right to find examples by clinical area.

If you have an innovation case study you would like us to publish on the portal please contact the Innovation team at england.innovation@nhs.net

Point of care CRP testing for respiratory infections in primary care

Historically, antibiotics have been prescribed for many patients with an acute uncomplicated respiratory tract infection (a cough).

Evidence from studies suggests minimal benefit is achieved from the prescription of antibiotics, but it can be dangerous to delay antibiotics for a significant bacterial infection that won’t clear up naturally, so doctors have a big challenge in identifying who needs antibiotics. The Attenborough Surgery in Bushey, Hertfordshire is aiming to tackle that by testing patients in the GP surgery for a biochemical marker of bacterial infection called C-reactive protein (CRP).

The use of CRP testing is included in the 2014 NICE guidance on the assessment of patients with suspected respiratory tract infection. The clinical assessment together with a finger prick blood test for CRP (with results in 4 minutes) using the Alere Afinion analyser is used to assess patients and helps decide whether antibiotic prescribing is appropriate. It is wide spread practice in many other countries to use CRP testing to help decide on appropriate clinical management. Since November 2015, the surgery has offered CRP testing for all eligible patients who visit with an acute cough, if clinically appropriate. They have already demonstrated a significant reduction in their antibiotic prescribing compared to last winter.

Impact so far

The scheme has reduced antibiotic prescribing by 25% and sharply reduced repeat appointments for coughs, with the proportion of patients re-attending from 24% to 4%.

Presented the work at two workshops in parliament on 25 May, hosted by Maggie Throup MP showcasing examples of good practice and practical strategies to tackle Anti-Microbial Resistance. The workshops were open to all MPs, peers and their CCGs

Next Steps

Use the Challenge Prize funding to further raise awareness of the scheme, extending the scheme to a further 10 practices and developing the business case for roll out across the CCG,

Building up training, mentorship and project development programmes.

Implement the second stage of the project – testing for lower respiratory tract infections in primary care.